| NPI | 1891999157 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH MARGERUM Director 580-765-2501 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 332800000X Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2024-06-27 |